In an effort to improve patient safety and quality of care within our own facility, and to contribute to overall improvement of patient safety and quality of care in the healthcare industry, St. Joseph's primary goal is to implement an Epic system, in a clearly developed and documented manner that will be of benefit to other small hospitals. This project will build on research and discussion around patient safety and quality of care at our national Learning Lab held in Milwaukee in 2002. This Learning Lab was attended by nationally recognized patient safety leadership representing leaders from organizations active in patent safety. Community-wide diffusion of the Epic system will begin at our current small hospital as the lead partners and transfer to our new facility upon completion of construction and extend to multiple clinic sites, a community retail pharmacy, a new residential hospice facility and an 18-bed skilled nursing sub-acute care facility. We will document our safety-driven design principles and discuss the role Epic has in meeting these design principles, either directly or indirectly. Further, we will design around precarious events, specifically medication errors, by identifying the prevalence of medication errors, near misses and preventable adverse drug events in our current manual patient record and with our community partners systems and then again after Epic is implemented. We will measure the length of stay, cost per case-mixed adjusted DRG and customer satisfaction in our current system and then again after Epic is implemented. Finally, we will develop and document a clear HIT implementation report that can be utilized by AHRQ, other small community hospitals and research organizations. [unreadable] [unreadable]